The Missing Piece in Longevity: The Top Gerontologist on Aging, Joy, and the Science of Thriving

The first time I encountered Dr. Carrie Burnight wasn't through a lecture or a book. It was on social media, which these days is where some of our most surprising teachers appear. But it was at Dr. Burnight who caught my attention. It was her mother, her 96-year-old mother, demonstrating the basic exercises she does every day to stay strong and mobile. I watched this vibrant woman get off the floor and get back down with ease. I watched her speak with clarity, humor, and presence. Here was someone living independently, firing on all cognitive cylinders surrounded by love and joy. And I remember thinking, I'll have what she's having. If this is what 96 can look like, I'm in. Because that's not the model I grew up with. My mother and my grandmother's later years are marked by dementia and frailty and loss. Their aging was not joyful. It was painful. So when I saw Carrie's mother and then I saw Carrie's work, something inside of me lit up. Especially because my social media feeds, like many of yours, are crowded with longevity experts making bold claims about cold plunges, peptides, protein targets, red light therapy, mitochondrial hacks, and supplement stacks. Everyone is talking about lifespan and health span, but very few are talking about whether we actually like the lives we're living. And then there was Dr. Carrie Bernite, a gerontologist, a scientist, a professor, a national leader in aging, a woman redefining what longevity even means. Carrie taught geriatric medicine and gerontology for 18 years at the University of California Irvine School of Medicine. She helped lead the nation's first elder abuse forensic center and has been an advisor to the Department of Justice. Her message is grounded in a profound truth. The key to good longevity isn't how long you live. It's how much you love the life you're living. This is the heart of her groundbreaking concept, JoySpan, which is also the title of her book, full title, JoySpan, the Art and Science of Thriving in Life's Second Half. JoySpan is the idea that longevity is meaningless without joy, purpose, connection, curiosity, and meaning. JoySpan is the missing piece between lifespan and health span. It asks, I'm here, I'm relatively healthy, now what? Women in midlife don't just want more years. We want better years, years filled with joy, meaning, and connection. Dr. Carrie Bernite is one of the clearest, most inspiring voices showing us how to create this exactly. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to UnPost, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life. The views and opinions expressed on UnPost are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. Dr. Bernite, welcome to UnPost. I am delighted this is my favorite podcast and I am so grateful. I've been binge listening to them every single one. Really? Yes. Okay. Why did you write Joy Span? I wrote it because I wanted to have a book that I could hand people instead of Xeroxing journal articles. This is why I wrote the new metaphor. Yes. I would try to translate it in the margins. What they just mean by that is to make sure that you recognize that actually gratitude is powerful. It seems like fluff, but it isn't. There's a practice that has been shown time and time again to impact how people experience their lives. That is simply when you open your eyes in the morning or before you even open your eyes to on your hands list out 10 things that you're grateful for. Because humans, we have the problem of doing the opposite. You open your eyes and go, oh, my mom's in the hospital and my kid's getting a divorce. And then the brain sees more of what you have put your attention to. So by proactively thinking, oh, this bed is really comfortable. My sweet husband breathing heavily, this golden retriever, the fact that I get to meet a new friend, Frothy Cappuccino. I get to go to my next door neighbor who's having a hard time with her divorce. Like to proactively put this practice in place. If it was a medication, again, we would be all like, oh, we should be taking this, but it's just a free practice. And so that gratitude is really powerful. So when I got the study, I tried to just put it into a book and every single page I kept trying to think, make this practical, make this when people are waiting with their mom at the doctor's office and going to pick up their kid and dealing with work where they feel like they're going to get fired for not showing up for all this caregiving. So let's start at the beginning. What is a gerontologist? I get that a lot and I get a lot of misunderstandings of what it is. So a gerontologist is a person who studies aging. And the thing about aging, it's another word for living. So it encompasses everything. So our studies were, of course, physiology and biology, but also psychology, sociology, philosophy, public policy, economics. So it's been, I didn't know it because I started kind of young into it, but in my opinion, is the most interesting line of study. What drew you to this? My mom and dad going along, doing their life, had two high schoolers, they're in their 40s, feeling like they're kind of getting it together. And my mom thought that maybe she was having some menopause, perimenopause, something about 57 years ago. And so she went to the doctor and the doctor said, it isn't actually that it is that you're pregnant. So when I was born, my dad already had entirely gray hair and people, I remember, mistook my mom for my grandmother. So when people would talk about older people in a disparaging way, which is all the time, I heard it because I felt like they were talking about my parents. And so it was a gift because I had a heightened awareness to the fact that people talk a lot of smack about older people. And what was your path to become a gerontologist? Like, you know, that's not like in the guidebook. No, high school. So I went to UCLA undergrad and there I studied sociology, which I was loved. And then at the time, when you didn't know what to do, you applied to law school. So I did that. I applied to law school. My husband and I both got the same score. So that in my mind, yes. So I thought, okay, we're both, he did end up going. I didn't end up going because I was so lucky. I was in a huge lecture hall and it was about four or 500 people in there at UCLA and a woman way down there said, I'm a gerontologist. So I stayed afterwards and I worked my way down and said, what? And she said, yeah, I study aging. And I said, how do you do that? Well, actually for you, right in LA, there was the first gerontology school, USC. And so that very day I got my old beater car and drove over there. And the first person I met there when I said, I'd like to be a gerontologist. Maybe I could be a professor or get a PhD or something like that, which again, I didn't know what PhD really was. Yeah. And I did it wrong. That sounds amazing. Middle P, big age, little D.S. And she said, well, that's for scholars. I think what you might be interested is the master's degree. And I said, why is that? Just how you look like maybe you wouldn't be smart enough for this. So I applied to the PhD program and I didn't get in. And then I did a year in the master's program and applied again. And so that's like the first lesson right there is we can't all do stuff, but society has told us forever as women that we can't and that we're not enough. And then put on top of that age is a mission. Yes. That I realized, like one of the gifts of menopause is my give a shit factor is gone. Yes. And I stopped asking for permission for everything. Yes. And not that the authority figures in my life, authority figures, men, were demanding this of me. It's just like was ingrained in my psychology that I must have permission. Like I'm only a doctor because I was allowed to be. Yes. You know, and so I love the way you say that because forever, like like some self reflection, I'm like, I have asked for permission for everything. May I do this? Can I study that? And then when I made the decision to leave traditional path of medicine that had been carved out for me by the same authority figures. And I had a good life, you know, money, respect, great position in the community. And then to go off on my own tangent and study something that no one thought was real. It was a big deal, but I had to give myself permission to do it because no one was willing to give it to me. And the full circle is you are giving women permission. So hopefully. Yeah, you absolutely are. You know, every episode I've listened to, that's really what I've come away with. That's my goal in the podcast. Overall, is that I wasn't doing this because women are overall thriving through this transition. So many of them are getting knocked up side the head and left on the side of the road. They feel that way. Yes. And I thought this this podcast, I want to hit medicine, I want to hit psychology, I want to hit finance, I want to hit divorce, like all the things we've covered so far. I want to hit aging, like real aging, not the fake bro aging. Right. I'm so glad you say that because now I want to talk about longevity culture. How do you feel about it? You know, and what you see on social media, I have a very biased view because of what the algorithm serves me. Yes, I too am served so much longevity. Bro living and aging as a competitive sport. Oh, my God, I feel like it is the longevity hunger games. Yes, exactly. What the hell is going on like the Olympics? I think that on the one hand, we want to maximize our health. That is good and healthy and we should maximize our health. But as we're doing it, we're also thinking to what end in order to do what? Is it to take a walk on the beach? Is it to be a good father? Is it to contribute to have a program that's reaching people? Is it to finally write a book? Like to think of think a little bit more about the why and this age by society where we're just going, going, going, gives us no time to think. Being kind to other people is a is a real strength and being sensitive is not a weakness. All these things, the strength and competition model to me is taking away from how great life can be, you know? And so if we could really lean into it and say when we were young, we were authentic selves. We wore tiaras and boots and tights and danced around kids. When we were little, we did our thing and then society pushed us in and they said, we're beige and don't talk too loud and don't cry and don't cackle. And so we started. But older can proactively be a time where we let ourselves are authentic selves out and to sing and dance and have kindness and to let yourself be foolish and to like say, yeah, like I got a really huge ass right now. Well, you know, like to to live and lean into it is so liberating. And when we see people doing it, when we see role models like that, we can't get enough of them. I know. So if you could cut through the noise and serve for our female listeners, at least, give her three tools, three things that will help her actually move the needle on aging, what would they be? The first is to picture right now the best possible future you. So you might be in your car, you might be at the gym, you might be laying in bed, you might be crying right now, which is just fine. Picture that version of yourself and what are you doing? And are you enjoying a hike or a sunset? Do you have a kid on your lap? Are you hugging a cat? What is that best possible self? Because we work toward what we imagine. And so this thing of picturing yourself like, I'm just going to be this hideous, irrelevant, suffering person with tubes all in me. That's really dangerous. So that's step one, your best possible future you. OK. Step two is to cut out that internalized ageism noise and recognize it when it comes and give yourself grace. Because of course you think that because you're all day, every day told that message that it's not OK to be old or that to say someone is old. Recognize that your words matter. So I always say older adult. That's the terminology that I use more than senior, more than elderly, certainly more than honey, cutie, babe. Right. So think about just the most adult time that you ever be is older adults. And then the third is to pick up your phone today and call somebody who you've maybe lost touch with and just say, I was just thinking about you. Would you want to get a cup of coffee together or knock next door is to really make these connections and know that our lives depend upon moments like this where we're connecting and feel seen and heard at times that it feels really lonely and really frightening and really overwhelming. But I want to go back to joy. Yes, yes. You have said that joy is not a luxury add on to aging. So my social media is filled with right now hockey players, which I'm totally OK with. And a lot of gross science talking about living to 120 and all the fancy things are doing to get there. There's not this a lot of talk around the life that they're leading. Yes, no. Yes. That seems really lonely to me to live to 120 because most of the people you surrounded yourself with your whole life aren't going to be there with you. Right. So you've described joy as a vital sign. Why do you say that in the study of aging and from doing it, kind of having a front row seat of thousands of people of aging. What I found was that people were not thinking it through. And I think that's still the case today. So they think, if I just do this, if I just do this, but let yourself think the outcome is that we have limited time on earth. And so when we start with the end in mind, it's not a failure to die. It's natural and we're supposed to and we're going to and no amount of VO2 max or green drinks is going to change that. So absolutely, we want to live as long as possible. Absolutely, we want to be as healthy as possible in our mind and in our spirit. But even more than that, like, why it's the quality of our life. And so when I looked into quality of life, you know, I thought about, could I call it well being span? Could I call it quality of life span? I one day saw that the American Psychological Association defined joy a little bit differently than it's used in everyday social media. So they define joy as well being and life satisfaction. And so then I thought it's not too much to ask for joy in longevity. And again, when I asked permission, if I might be able to make up a word, people said, oh, no, no, you can't really have joy. You can tolerate being old, but not joy. And that's not true. So joy is different from happiness. OK, there is a difference between joy and happiness. Yes. And I love starting there. And I would, if I thought it was just the same thing, I would say, oh, give me a break, lady, my husband just died and I was just diagnosed with ALS. You're not going to be happy all the time at all, particularly as we get older. It's hard. And there's a lot of real stuff that's coming our way all the time. All of us, whether you know it or not, everybody's carrying a lot. And it gets to be more so as we get older. So happiness is real up and down, it's circumstantial. It's where we get into toxic positivity, like just make everything OK. Dangerous, fake, not it. Joy is something that's inside out the inside out job. And where I really most learned about it was from the work of Victor Frankel. So Victor Frankel was like you and M.D. He was a psychiatrist. He was in a concentration camp. I mean, I don't think anything gets worse than that. And yet what he wrote is that regardless of circumstance, you can maintain your freedom because it's internal. So this spiritual freedom of who you are, you can have all the awful, awful things that this human life brings and still have joy. And to me, that is so hopeful because there's so much fear around aging. And when you say, yeah, stuff is going to happen. And it's not because I'm doing it wrong. But when it does, I'm going to have prepared myself to be able to walk with the hard stuff. And that is joy. And you can't always tell. So sometimes joy looks like a smile. A lot of times it doesn't. So I have patients who have two women looking out the window at the trees. One is miserable and suffering. And one is has the same facial expression, really experiencing joy because it's this inside job. And so each of us can cultivate that. And there's all this science around it, which I didn't know. I was always under the impression that that's a personality trait. Right. You know, there are just certain people who are always going to be happy or always going to see the positive or the bright side. But you're saying that this is a skill. Yes, I can be learned. Are people born with different dispositions? Absolutely. Any of us who are parents know that you come with your you come with your whole self. So yes, personality and and upbringing and trauma inform a lot of who we are. If it was all of who we are, then there'd be no point in this. But what the research shows is that in the same way that we can cultivate our physical strength, we can cultivate our well-being and our internal strength and that regardless of where you are now, these practices can improve how you feel. OK. And that feels so hopeful. All right. So we're going to get into some strategies later. But I want to talk about a little differences between men and women, because what I see in my family is the women are living longer than men and my maternal family follows the population curve, where women are living four, six, depending on who you read, years longer than their male counterparts. But they are suffering more. They have a higher burden of suffering. Yes. And that suffering isn't limited to them. When they're suffering, their children suffer. People don't want them to suffer. So everyone's all in to try to relieve this. But the attitude is I'm getting old. This this is terrible. This sucks. You know, and there's nothing I can do about it. Yes. To make what's inside of here better. And that's what I've seen in my own in my own family. So do you see that on a population basis with the patients that you see? I really do. Between men and women. Yes. So when we start with women, because there are more of us and we do live longer, the popular thought about growing older is that it's something that happened to you. It just happened to you. But what we're learning is that we have much more of a role in what that older looks like than we ever knew possible. And it's funny because a lot of what we've learned, it's the corollary to the physical part. So our shared colleague, who we think so highly of, Dr. Vanda Wright, she has that neat acronym, FACE, that she talks about physical strength, being flexibility, aerobic exercise, carrying heavy things and equilibrium balance. And you don't just look at somebody who is fit at 90 and think, oh, it's just love. No, every day they were doing those things and that it resulted in a different aging trajectory. It's not that they didn't grow older. Of course we all grew older. Yeah. But they grew older in a way that we want to be like we as women. The same is true with our internal selves. And they even go along with those four. You can even use FACE. So with flexibility on our body, we're talking, we're talking about flexibility. But the flexibility is the flexibility in life that I call, the research calls, adaptation. Knowing that stuff is going to happen in these 100 year lives that you never thought was going to be to happen. So our daughter, when she was diagnosed with a brain tumor, I didn't have that on my radar that that could even happen because it could happen to me, but not to my daughter. Yeah. So that flexibility or that adaptation to say, I am going to not get rigid and I'm going to try to work on going through life in a way that has some looseness and some internal saying. Self-regulation. Yeah. So it's self-regulation, but it's also looking like opening your eyes instead of going, if I just do everything right, nothing bad is going to happen. That's not true. You can do all the stuff and stuff is still going to happen. But the question is, how are you going to respond when it does? How are you going to go? I have bolstered myself to be strong enough that when my husband gets a diagnosis, when I get a diagnosis, when my best friend dies out of the blue, that I'm still going to be OK because I've cultivated what in a physical part would be flexibility, but internally in research, we call adaptation. So that's one part. We'll go into these deeper, but so that's the flexibility adaptation. The second one that she talks about the aerobic exercise. So we talk about making sure that your heart is getting taxed so that it can keep going for the whole 100 years. You want to stress out the body a little bit so it adapts in a responsive manner to be stronger. Exactly. MD, PhD. So when you think about the internal part of that corollary, you think about heart and the heart part is the connection. And so connection is incredibly powerful. And in that Harvard study that people refer to is an 85 year study looking at what was the biggest predictor of how people aged. It was connection. It was other humans and recognizing that it's not just a nice to have, but it's a necessary. So we've done the F, we've done the A, the C. She calls it carrying heavy things, so it's weightlifting. And on the internal part, that carrying heavy things and that growing muscles. I'm just going to talk about as grow. So continuing to grow. We, as humans, are designed to keep challenging ourselves, to keep doing hard things, to keep expecting of ourselves. And yet if you buy into the societal myth that it's all downhill, you're not going to do that. You're not going to put yourself out there anymore. You're going to think, oh, that ship has sailed too late for me. I'm not fit enough. I'm not pretty enough. I'm not young enough. Like all this baloney that's keeping us back. So making sure that we are growing and we'll go into that more. And then the last one, the E that she uses was equilibrium. Are we physically doing things? Are you standing on one foot to brush your teeth? Are you doing the things? And on the inside part of us, that equilibrium is what I call the balance between self and others. So what you don't want to do as you get older is become all about self. It's the kiss of death. So I also write about it as giving. Making sure that as humans, we have the opportunity to give our whole life long. And if you buy into the myth that aging is all decline, you stop giving. Yeah. Because you don't think you have anything to give. Therefore, you go into this kind of suffering in late life that was unnecessary. Had you known how important it is to have all of these internal parts? So again, that you are adapting, that you are connecting. That you are giving and growing. To me, it feels like it's opening up a whole new world of saying, do all the physical stuff because this meatbag matters. Yeah. But it is not the end of the game. By far. That's what I see people focusing on is the meatbag. Yes. You know, the bones, the muscles and and not the brain. Yes. You know, brain health. Yes, but not the psychology, the psychological part of it. Yes, like who you are. And I was lucky early on because I would work with older people. I would have two people with the exact same diagnoses, same socioeconomic status, same genders, same race. And yet they were having such a radically different experience about growing older. And that was fascinating to me. You know, why? Why can I not wait to get away from this person? And why is this person like I can't get enough of them? And how can I be like that person there? This divergent path. And when does it start? Typically, yes, you have group A who is going to thrive with joy, regardless of the usual aging hiccups, all the things that happened to us with aging. And then someone exactly like you can take twins, you know, and take them down similar paths, but they can have radically different aging experiences. Where do you see this bifurcation? Yes. And why? I'd say it's different in different people. And so I'm going to use a tangible example. My mom. OK, so my mom had me late in life as a surprise. You know, the usual hard stuff of the son with leukemia. They went through bankruptcy. She'd be the first to say she's not a glass half full kind of person. She was going along believing the societal lies that it's bad and shameful to get older. So she was kind of going down a path. And then happily, I was so lucky to discover this whole research that was hiding in plain sight in academic journals that nobody was reading or talking about. Oh, God, the same in menopause. Like, like there's so much good stuff out there that has just been hidden from the world. Exactly. This is some of that, though. So yeah. So as I would uncover them, I would share it. So of course, you share it with people who are close and I would say, Mom, oh my goodness, did you know, for example, that research out of Yale University shows that your aging beliefs, what you expect aging to be like impacts. How long you live with people who think that it's all decline, living seven and a half years less, that it impacts inflammation, that it impacts disease expression. It's something as simple as what you think about aging. So then we dug into it and she started to shift. She was was probably in her 70s that she started to think about things differently. She stopped telling herself, it's a shame. I don't want to tell you how old I am or having a senior moment. She dropped all that nonsense that is so tempting for us to all do, because I would argue that we all, myself completely included, have internalized ageism that came from a lifetime of hearing the message that it is bad to be old and it is ugly and you are less relevant and you are all these things. And the reason the message is so powerful is because it's so lucrative. People make billions of dollars telling you, oh gosh, if you should have some fat come over the top of your pants, which is just skin, by the way, that it's like somehow you should be so embarrassed or that if your teeth aren't sparkling white, you somehow are less than. There's this loud message and it's in all of us. But when you start to recognize it and go like, I'm not going to waste this time on Earth thinking that so that somebody else can make a buck and that there's no way to stop aging. So if we can change the question from how not to age, let's talk about the difference between men and women. I don't see men feeling shame about aging as much as I do women. Right. I know. And I didn't even bring the physical appearance of aging. Yes. You know, I love that. And you were so kindly redirecting me back to the question about men and women because I didn't talk about men at all. I never talk about men. In my practice, I have one penis to take her off. Yes. Yes. It is different from men and women as it has been throughout our lives. And I think women are carrying much more because of the societal expectation you think about. I mean, what that does to our psychology, you know, the shame over what is naturally physically happening with gravity and sun exposure and all the things, you know, yes. And but I think that's that's spilling over into other aspects of our life and how this feeling of women talk to me and I'd love to hear what your patients say. Because I'm at the transition, right? You tend to get them when they're older, this feeling of disappearing. Yes. They feel like no one sees them, that they're invisible. Yes. And I think less. I think the boomers are really feeling this right now, that generation. My Gen X is saying, I am not going to put up with this. And I think the generations coming behind us are going to have it a lot better. Yes. But it just kills me this invisibility. Yes. That women are experiencing because I don't I'm not letting myself feel invisible. I'm getting I've never been louder. And thank heaven for that. But I stopped asking for permission. Social media can be great and can be terrible. But I sometimes post with my mom, who is next month going to be 97. And so some people say incredibly nice things. But one out of many was like, oh, my gosh, the daughter, 56, looks older than the mom at the time, 96. And I thought, why do you think that it's not bad? This whole thing that the big prize is to not look your age. And if you could just look young, be young, whatever. So I realized that, yeah, I'm a gerontologist and I'm ageist against myself, unless you consciously look at that comment and say, like, screw you, I don't care. That doesn't matter to me. That doesn't define who I am. If I happen to look younger or older or whatever. But I think it takes all of us being pretty strong and just in the same way that we don't believe it anymore when they say, oh, women can't run companies. Watch me. You know, more women our age are starting companies right now. Like the number one person to start a company. I think I just read this was between the ages of like 45 and 60 or something like that. And I'm like, oh, me, I'm one of them. Yes. So I did. And we're changing it and we're changing it for the people who come behind us. But it will always have to start with a person. And I think every single one of us, like if you are listening to this podcast right now, the next time you go to a mirror, in addition to a voice that will tell you something like, oh, no, you got all these. Yes, exactly. Look at all this. Then you say back to it. Of course, that's how next bend. I've been here for a long time and it's going to be more and more like that. And that doesn't diminish who I am. And it doesn't even make me less attractive. It's society has told me that. And I've believed it. I've given them my power. Have you ever felt like you were living just a B or B plus life? It's so dangerous to live that more dangerous than a B minus or a C plus life because when you're living a B or B plus life, you don't change it. You think it's good enough. Is it? I'm Susie Welch. I host a podcast called Becoming You. People think, OK, an A plus life is not available to me, but there is a way. We are all in the process of becoming ourselves. Listen to Becoming You wherever you get your podcasts. One of the things I'm curious about and I'd love to know your perspective when we talk about the differences between women is the fear around aging. But women, I think the fear, what they're fearful of is different. We all fear looking older. That's we're socialized for that. OK, but women fear being a burden. Yes, more than men. My husband, I don't think we're thinking about it now because of what our parents are going through. I've talked about my mom, but his mom, his dad died in February after a protracted disability illness that took away his ability to move. And it was really hard, really hard. And his mom stepped up, even though she had stage four breast cancer, metastatic booster for bones and was doing the majority of caregiving. So we're like, we want to be benefactors and not burdens, but I think that's more of how women are thinking about how they age and what they're fearing. Do you see that? Very much so. Yes. So the fear of being a burden. Comes from many areas, but one part is also societal talk about independence. I say it all the time. I want to be independent, but maybe I don't know what that means. Right. So people do and they'll say, people will say to me, I'll be OK as long as I'm independent and when I really dug into it, humans are in fact interdependent. OK, you've always been interdependent, even as a teenager, maybe it was girlfriends. And we're certainly with partners and with our children and with our grandchildren. So starting to think about interdependence really helps for this burden thinking. And the other thing is we love to be the givers. So women feel praised and feel good when you get to be the one to say, are you sick? Let me bring you some chicken soup. I will do that right now. But we don't think it through that when we can accept we're giving the other person that givers high. So to learn to accept help, that it's not wrong, that it's not less than you're giving them giving in the same way that you have gotten to give. And so again, that takes some rethinking. You talk about internalized ageism. Yes, as this force. You know, how do you think that's showing up in women? So everybody's talking about AI and I'm all about IA. So IA is internalized ageism. And it is the fact that ageism isn't just other people judging you, which they are, but it's also the most damaging, which is you judging yourself. And is that dialogue in your head and it profoundly impacts how you age. So when you said you talked about that path, how some people go down one path. Step one, today is that everybody recognized that you have some IA, some internalized ageism, and that it is your job to be your biggest cheerleader. What does that sound like? It sounds like this. You're looking at your phone. I'm just going to use myself as my example. I'm looking at my phone and I go, oh, my gosh, I got 25 chins. Like, that's so bad. Now I start going like this. Then I say, are you less than because you have that? Do you can you make less of a contribution in this world? Do you enjoy sunsets less? Is that pizza less tasty? Are you less funny? No. Like you're buying into their stuff and you're putting it on yourself. We have the key to these handcuffs, but we don't realize we have. So it is, you know, a fancy term is cognitive behavioral therapy to yourself, which is replacing those thoughts. And when my patients start, I just say, note every time that you say something unkind to yourself, particularly when it's about aging related stuff, note it and come back to me. And then they come back and they go, I couldn't find my car. And I thought it was because I had dementia. I couldn't, you know, nobody turned their head to look at me. So I figured I was less than a lot of it's constructed. And you think about people who don't have the perfectly tight skin and they have luchines, they're living their lives in a great way. It's not about that. We make it much worse on ourselves than it actually is in the world. Let's talk about aging in place. I think a lot of our listeners are in our age bracket when we looked at demographics and they're thinking about their parents or thinking about, you know, where's this going to go down? How's this going to happen? What do women really need to understand about things like fall risk and bone loss and mobility and medicine? And I know you went through this with your mom. Yes. So aging in place is the preferred over 90 something percent of people want to stay at home and being able to maximize our ability to stay home matters. And so, of course, all the strength and mobility training of making a house that doesn't have such treacherous fall risks, recognizing that at every age, you need to hold the railing every single time you walk down the stairs. Nobody thinks they're going to fall ever. But I have patients at age 40 who are carrying the laundry like this. Me. Me. I live in an elevated home. Yes. I don't ever, ever, ever. The lights are on and I'm holding on to the rail 100 percent of the time because I fall in twice, you know, and holding the laundry going down the stairs. Yes. So every single time stopping yourself, going, I'm going to be the person who slows down and does these things. And then recognizing that there are no hard and fast rules. So we don't ever promise to our parents, even if they ask us to promise me, you'll always let me make it so I can age at home or promise yourself, I will always just be here. We don't know what's going to happen. So, yeah, let's be in our own homes as long as possible. Let's do those things, but also be open enough. So my mom has given me a gift. She at almost 97 is in her own home, but we've done a lot of modifications. But she has given me the gift of saying, if there comes a time that we need to be in a nursing home, don't, you know, don't be hard on yourself. It's OK. I'm enjoying the time. And that's that's a gift. What frustrated us with our parents' aging is there were no modifications made and full on refusal to even think about modifications being made for what was going to be inevitable. Yes. And a lot of, you know, when I'm talking to my friends, there is frustration with this generation of always having to be on call for the emergencies that were preventable. Yes. I love that you bring this up. This is all day, every day. OK. These are the calls I get when I'm driving. Everyone's like taking notes right now. OK. If we're lucky enough to still have parents, it's not easy and it's not clean. And I had never used the term aging gracefully because I have never met anyone who went through their whole life and it was all graceful. It's hard. There's a lot of hard stuff. So I think one important part is that with our older parents, when a person has cognitive impairment, it is one thing. When a person doesn't have cognitive impairment, it is another thing. So for now, I'm going to put cognitive impairment dementia over here. All right. I'm not talking about people who have the capacity to make decisions for themselves. They are your parents. Don't agree with what they're doing. Right. We don't think it's safe. We can't parent our parents. Yes, we can't. No. I know. And here's the saddest thing. It's so, so sad because what makes us good parents often makes us not such good adult daughters because we want to come in hot and go, you know what you need to do? You need to la la la la la la la la la. And then we then the parent goes, oh, hell no. And then we get on the phone and we call our friend and go, you cannot believe how stubborn my mom is. She blah, blah, blah, blah, blah. I get it. But also we each have this life to live. So don't do it like you're, let's say if you're working with somebody who won't make any home modifications. Your biggest thing is don't do it that way in your life. Change it in the future. In the meantime. OK, so when my advice is to give yourself at least a fighting chance. By not going in so hot. OK, so you are going to be the mother in this scenario. You live with some really treacherous stairs and there's no railing and you're like, I'm fine, Carrie. Tub. Yeah. Hi. The tub. Yeah. The whole thing, whatever you're drinking, you're driving, you're doing all this stuff. So I'm the adult daughter. I understand the inclination. What we want to do is I want to come in and fix and tell you what you need to do. If it worked, like, OK, it's just that it doesn't work. And the reason it doesn't work because it puts the older adult like this, like, you don't tell me what I'm going to do. And I got a taste of it. So this is a tiny example, but I was looking at my phone and one of my adult children, I was doing it right. It's just taking me a sec. I whipped it out of my hand and said, let me do it for you. I was like, no, no, no, I can do it. I was just like taking a second. I thought that little tiny taste is the same taste of going in too hot with your aging parents. So I'm not saying you don't have legit concerns. That is all legit. But going in like this, mom, tell me about what's on your mind a lot these days. Shut up. Let the mom talk. Give her time, time and let her see she's dipping her toe in the water to see if you're going to try to take over and take away her autonomy. Because there is this continuum on the one end is safety. People who have adult parents, they're thinking about safety and they think that that's all there is. It is not. I swear that is all anyone's talking about. Here's the other end of the hidden continuum that matters so much. Autonomy. You know who autonomy matters to the older adults. It means that I'm an adult. I'm not aging is not a second childhood. You might not agree with me, but I'm going to do things my own way. So autonomy matters and it's not one or the other. We're trying to balance these scales. But when adult children only are looking at safety, they're going to be in for a battle. And so when people I know call me and say, what should I do? Step one, close your mouth for a minute. Slow down. Show your mom that you're not going to instantly solve her problem, minimize her problem, say, oh, it's easy. All you do is this because it just makes them less than. And they said, what should I think about? And I said, you know, sometimes how a dog will lay on their back and like just put their belly up sometimes in my mind, I do that to myself. I'm like, just lay down. And let the person who has had more years on this earth than you have had talk and problem solve and be heard and seen and listened to and valued. And if you can give it some more time, maybe even in that first session, first few sessions, you don't offer your genius, 50 something year old wisdom. You just be quiet. Then the next time they're going to be much more amenable to care partnering with you to create a longevity that works. And I'm going to give you an example with my mom. My mom was crazy sick in her eighties with C. Deaf. And so it was like just horrific diarrhea. She lost something like 30 pounds. She was in the hospital for months. We didn't know if she was going to make it. And a lot of people do lose their lives. So when she came home, she was incredibly weak. She's a widow. She has a two story house. So I, without consulting her, thought I was doing a very kind, nice thing. Is I got a downstairs hospital bed. What a nice solution. You don't even have to walk up the stairs. I got you this bed. I even paid for it. Look at how great this is. She was quiet. Then I went into the other room. She picked up the phone. Some found the phone number and said, take this bed away today. This looks horrible in my house. I won't have this. My reaction, not the right reaction. I was mad. Like you almost died and I helped you. And now you won't let me. But the thing is, I didn't sit with her and say, let's think about the stairs. She probably would have come to that solution or another solution, which her solution was to sleep on our couch. And she loved her couch. Her couch is super comfortable. The TV was right there. Something that we don't know about older, but that is true in the literature is that we have more a neurological integration between our left and right hemisphere. And because of that, we can help my listeners understand. What I mean is that we are able to draw upon the left and right hemisphere of the brain working together and the fact that we've been solving problems for 80 or 90 years to come up with solutions that younger people don't come up with. But in our ageist society, we don't realize the problem solving ability of older adults. So we don't listen. My very best example is my friend who has passed, but he had a MD, PhD, Geriatrics, Gerontology, I mean, you really knew. And his name was Gene Cohen. And what he would do is after work from Harvard, he would come and pick up his car. His parents in their nineties with their walkers would take the train. He would put them in the car, drive to his house, eat dinner together and then drive home. Great. This day, he was late. They roll up dumping snow before ubiquitous cell phones and they're just out there in the cold. So then they look around. They see a pizza place. They carefully with their walkers walk over to the pizza place and they say, you know, we'd like to order a pizza delivered to our son's house. And when you deliver that pizza, we'd like to ride along in the car with it. Oh, my gosh. And that is the problem solving that younger people don't have as much to draw upon. But we would be like, no, they had a great solution if we are quiet enough to value the strengths of older and to see it in ourselves. So there was a time where I was working in an environment where everybody was in their 20s and 30s and I was in my 50s and I found myself in the beginning quiet about it. And then I thought, no, I've been around. It's safe for me to to share your lead into it. And I did and it really made all the difference. So there are things that get better as you get older. So one is problem solving. Another is you don't care as much what people think that. So liberating. I know that is the best. There is a greater emotional regulation. So your research at a Stanford showing is not as up and down, except for when you have the perimenopause and menopause part. Other things that get better as you get older that people should know is sex can, doesn't always, but it can. And it's I love that you were talking about it and you were talking about it and navigating it. You know, desire is different. Sometimes the women have less desire. Sometimes the men have less desire and that they feel shame associated with that. But other things that I was going to talk about was you have a greater appreciation of beauty and the simplicity, a greater humility. And isn't that what our world needs? A greater potential for depth of spirituality, appreciation of music, heart and nature and just having a cup of coffee. So with my patients, I always start at the end. How do you hope to be remembered after your time here is done? We don't know if that's tomorrow or if that's in 40 years. We start to talk about that. Not a person I've ever talked to and talking to thousands of people said, oh, man, I just hope that my VO2 max is better than anyone else. Or like, I hope that people really think I'm rich or people think my skin looks tight on my damn neck. People say, I hope they knew that I loved them. I hope they saw me as somebody who could throw their head back and laugh. Like these things that matter can get better as you get older. And because of that, the best possible future you can be older you. And how hopeful is that? So that mindset reshift from a decline aging mindset to a mindset of not wait to meet that Dr. Mary Claire at 98 because as great as you are now, you're going to lean into these strengths of what really matters. And we have the choice to do that. So a lot of our listeners are like, OK, you're helping, you're giving me tools to help deal with my aging parents. But I want a different future for my children. So say we're in our 40s and 50s, help us with a toolkit, a roadmap to die with joy. I would love to. OK, so step one, I like that you put die in the beginning because the recognition that our time here is limited and that that is not because you're doing anything wrong and that you came into the world pretty messy, pretty bloody, messy, weird stuff on you, crying and you go out pretty messy. Oftentimes that doesn't mean you're doing it wrong either. And it doesn't mean as an adult daughter that we're doing anything wrong if things get messy. So the toolkit is one, you recognize that time is limited and is therefore precious to you recognize that what you think about older matters. So throwing out the notion that old is bad. It's going to take some doing, but it makes a different. The research shows it makes a difference. Then those four areas that are verbs are practices. And so there are joy practices in the same way. You don't take a weight in your hand and do one and then go, am I strong? Ah, you do it every day. You start to do little things every day. So the kinds of things of with these four areas, these verbs, continuing to grow, to really put some like, am I doing hard things? Am I figuring out? Are you talking physical, mental? Like, what does that look like? Yes, I love that. It's different for different people. So I work with a lot of people who have put aside either by choice or by being forced out of their career roles. Many of the roles gave them a lot of meaning, a lot of challenge, a lot of like, this is who I am. I mean, there's the classic story of the man usually who retires and then just plop, yes, yes. Because I think what you're stepping out of is is a identity, but is also that growing. So that first step with grow is continuing to do hard things. And so to think that it takes a little bit of thinking where you go. And I have a chapter about it in the book where you think, OK, how am I growing right now? And for you, for example, right now, you're like, I never did a podcast before. And here I'm doing a podcast that's reaching millions of people. It's because, you know, you said I'm going to step out and become a novice at something. And for many people, that growth is nothing that people see. It's just you knowing of saying, man, I've got a piano in my house that's been sitting there for 30 years. The kids never practiced and did it. I never sat down. What if that was my grow? Or maybe I have another patient. Her grow was to become a good listener. And I loved it because listening is that something that's going to change your life? Absolutely. She read all the books about listening, how to be a communicator. And then, ironically, she has some problems now. She's more contracted now in her 90s and has a bit harder time speaking. But that listening was something that she could do her whole life. So every time I come to where she lives now, people are gathered around because they feel so heard by her. And I think that's something you could take your whole life long. So grow is not optional. It is like asking yourself. And then the second one is connecting. Don't just make friends and then they last the whole journey with these new 100 year lives, you've got to be really proactive. My mom has outlived almost every single friend. Right. And I see that with my parents. You know, their world's just got smaller and smaller and they weren't growing. And they weren't connecting with anyone new. Yes. So the sentence to give yourself is to be that friend. And that is the friend who remembers that it's been five years since your dad's passing and says, Hey, I remember your dad died around Christmas. Do you want to go out and talk a stories about your dad or, Hey, next door neighbor. I see that you're driving to chemo all the time. Could I drive you to chemo sometime or, Hey, person at the supermarket. We see each other. I don't know if I've introduced myself. I'm Carrie. Oh, you're Bill. So the next time you come, Hi Bill. I mean, all of these micro connections, if you could package up what connection, it would be the next ozembe. Like it is powerful, but you can't be on autopilot. And we've been taught to diversify our financial portfolio. Like you wouldn't put all your money in just one thing. The same is true with your social portfolio. What does that look like? So it means diversifying your social portfolio. So it can't be that you just go, Oh, I have this friend and this friend. We got all the way. The world's getting smaller. With age. One thing that my mom has done that's been great because I read about it and she did it was to invest in and proactively go after younger friendships. So she has a group of women and they're in their 70s and she calls them the youngs, which they love and they get together and they, you know, for them, they play cards and they get together once a month. And it's so great because they're learning from somebody who's ahead of them in the journey and she has friends who are alive. If you put the effort in and keep after it, you will have connection. It isn't just luck. It's complete effort and pushing yourself even when you don't feel like it. Yeah. Changes in sexual performance are more common than most people realize and support doesn't need to feel awkward. With MedExpress, everything happens privately online. Start by completing a short consultation reviewed by UK registered clinicians. If eligible, treatment is delivered discreetly to your home with ongoing support whenever you need it. You're not alone in this. Visit MedExpress.co.uk slash podcast to learn more. All right. So what about the woman who's sitting here, stretched then, overworked, still raising kids, dealing with aging parents? What would you tell her? I would say first, I see you and admire you and I love you and you feel like you're drowning and you are drowning and that you're a hero that nobody is cheering for. And that this phase won't be forever. How do they not destroy themselves? You can't be everything for everyone and you need to tell yourself in that nice voice you're doing your best. Your best is enough. And a kid maybe sometime will not get picked up on time because you blew it. And your mom is going to be pissed because you didn't blah, blah, what she said she was going to do. And you're going to tell your dad, please don't do that. And he's going to do it and then fall off a ladder. And you are not the only one in the world. There are other people in your family that you can say, you know, maybe they're siblings, maybe they're just cousins, maybe they're neighbors. If there is financial resource to say, like, I know that you don't want to spend any money with caregiving, but I simply can't do this anymore. And that's OK. I don't I feel like a lot of women don't feel like it's OK. I've had patients, you know, just tell me when they're telling talking about their family history, who have given up careers, jobs, the joy in their life, things that were like bringing them fulfillment and joy to be dutiful. Yes. And I see it destroying their health. Right. Ask yourself, what would happen if I let some things drop? And would there be ways to say, I can't. And sometimes I'll encourage my patients to cry to their parents. Like, say, it's OK to go to your parents bawling and say, I can't keep on like this. I know that this is what you want. I am this is killing me. I need to tell your spouse, to tell your sister, to tell the next door neighbor that it's good girl thing that we somehow are going to be able to do everything in save the day. Isn't fair. And it isn't right. And it feels like it's the only choice, but it isn't. I mean, I see their cholesterol, their inflammation levels, their sleep deteriorates. And I was watching a TED talk and I don't know where the study is. But when a woman rings into her home or moves into the home, when she becomes a primary caregiver of a dementia patient, her health deteriorates rapidly. Exactly. Her life expectancy shortens. Mental health and her risk of dementia doubles. Yes. And so talk to me about that. Yes, because I refuse for that to be my daughter's. Yes. So many of us live with family members who have cognitive impairment. So I also want to make sure that listeners are really clear what we're talking about. So dementia is an umbrella for a lot of different conditions. The most common is also a disease, but it also can be, you know, lewy body or there's a lot of different and some are even reversible. So sometimes somebody comes in with a dementia that is as a result of the polypharmacy as a result of taking all these medications. So with dementia, you know, you do want to get partnered with a care professional who can give you the information that you need to recognize that it's a disease process that a lot of times makes people act in a way that is really painful. And that it's that they're lashing out or that they're saying mean things or whatever, based on what part of the brain happens to have these neurofibular plaques and tangles. It doesn't mean it's not just like alcohol, they're showing their real self. So that's one thing I want people to know. That is my sister and I have had to really come to grips with that because the way that my grandmothers, my mother's mothers, dementia, her else, we think it was Alzheimer's now, but they didn't do that. You know, those tests weren't available back then. It was very peaceful, very calm. She faded away. She had some hallucinations and she was scared a lot, but it wasn't like this angry bitter, you know, like my mother's who will have these manic episodes. That is her brain doing this. This is not how she would want to be. This is not uncovering this hidden evil person, you know, or, you know. So that was hard at first. Yes, we didn't get it at first. We're like, God, she's just so mean. Right. We're being so kind and she's the kinder we are. I know it. It is not easy and it's very painful. And when you are care partnering with someone living with cognitive impairment, whether it's your parents or your grandparents or your spouse or yourself, you know, to recognize that we are more than just our brains. And it's not an all or nothing thing. So too often I find people say like, well, she has dementia, so and they just throw everything out instead of like what remains in terms of ways that people can still have exert some control over their lives, even with cognitive impairment. But when that burden gets so great to often the adult daughter and you think I am this going to kill me or give me cognitive impairment is that ability to ask for help, recognize that nobody and nobody could do it all all the time. And if there are resources either with the older adult or pulled within the family or services like to get that is such a gift to be able to hire people, even if other family members say, no, we don't want to do that or the person themselves with cognitive impairment is like, I won't allow anybody in my house. Oh, yeah, we've had to deal with that. We need to get pretty creative in saying, like in my case, my mom said, I don't want or need a caregiver, but I could use some help from you. And so like, well, because I travel and because I work, it can't always be me. And she said, no caregiver. And I said, so we tried a few different things. And in this case, I said, what about an assistant? Like, what if an assistant came for just a couple hours a day? It's different for everyone what they will allow or not allow. But coming at it a few different ways. Sometimes we can get to some creative solutions. So sometimes people say, well, my parents will allow somebody to come into a house to help with meal preparation, but that's it. And then maybe we could use that person to start doing some more activities of daily living, or maybe there's an extra neighbor who we could talk to. I wonder if I could in some way compensate you or trade goods and services so that you could help out. We need to get pretty remarkably creative in these really hard situations. And also know that our best is enough, even though it never feels like it is. Yeah. Let's talk about the difference between gerontology and geriatrics. Oh, it's such a good question. OK, so geriatrics. I know what it is. Of course, we're listeners. It's when you have an MD. So like Dr. Mary Claire has an MD, a medical physician and a geriatrician is somebody like a pediatrician who specializes. They have additional training. So if you can get a geriatrician when you get older, because it's so great to have this existing training, the problem is there are so few of them. There is, you know, thousands and thousands of people for every one. Mine is gerontology. So it's the study of aging. So my department at the university was geriatric medicine. But everyone else had MDs. I had this weird PhD and I did the research part and the grant writing. And what I got really into was the greatest suffering because you want to use your life in a way. So I focused on people who had endured elder abuse, neglect, financial exploitation, people who didn't have enough money to pay for services, were deciding between medications and food, people with cognitive impairment and a lot of these diseases. And what I learned from having decades in that heartbreaking area was that we can lessen the suffering by getting in with a lot of these things earlier. So getting in physically with the strength training, but getting in earlier with connecting humans with growth, with adaptation. So when people say, now you left your work in elder abuse and neglect, it isn't because I don't care. How can we prevent it to begin with? How can we fortify people so that we can maintain brain health as long as possible, have the social connections to have other people to drop on so you don't end up totally alone? So for everybody listening, regardless of the age you are, you can fortify yourself starting today, starting with little steps about what this new old age can look like. All right, let's talk about medicine and the geriatrics part of this. It is hard to find someone specializing in care of the older patient. And we've been very frustrated with some of the care that our parents have received. A lot of it was written off. So my mother-in-law had back pain seriously for months and months and months. And it was so bad when my sister-in-law, my brother, my husband's brother, had married this incredible woman and she had sarcoma that was kind of in remission when they married. The last few years were just fighting this in stage of the sarcoma. So she died. And my mother-in-law did not get on the plane to come to the funeral because she was hurting so much. And I looked at my husband and I said, something is wrong with your mom. He's like, she went to the ER. I said, did they immature? No. You know, here I am, the doctor trying to call the shots. I'm like, they told her she sprained her back playing botchy ball. She's in her eighties. I said, send her back. Insist. Say these words right in my chart that you were refusing to give me a CT or MRI to find out what's really going on. I'm like, something is wrong with her that she is not coming for the funeral. Chris. And so that's when they saw all the Mets and she had metastatic disease and had to go find the primary, which was her breast. And I thought this is because she's old. Yes. Had she been 25, they would have imaged her immediately. Yes. Regardless of if she had played botchy ball a month before. Yes. And she had suffered for so many months before someone took her seriously and decided to image her. Yes. And it's a tragedy. So my question to you, you know, look, you have such an umbrella view of this. This high view. Where do you think medicine is consistently failing us as older adults? Well, I'm so glad you bring it forward because it is consistently failing older adults. And there are so many places like where do you start? One time I was having some imaging done and it was cold. So I pulled up the little blanket, heated blanket thing really high. And I, the man who was working there pointed at me and said, is this for me? Because everyone else was older and that they just acted like, you know, that we weren't even people because, you know, this for me. Oh, God. I know. So you weren't even a person. You're you're an object. Exactly. And then you think about how often that happens. So I think, yeah, like we're dehumanized. Yes. And so we standing up for people that were with who are older and then also standing up for ourselves. And then the fact that there aren't enough chariotrations to care for everyone makes it so that every physician with this, because every day, 10,000 more people turn 65. So there's this more and more and more of us. Every form of medical practice has a geriatric component or has is going to be working with older adults. A significant percentage of my patient population. Yes. Would be considered to be geriatric. Yes. Because they have nowhere to go. Yes. You know, exactly. Yes. So I think we've tried to and the academic world put more aging care, more geriatric medicine into every kind of practice. But do you feel like it should be its own specialty like Pete's? It still is. And yes, I think it should be. And people don't go into it because it is hard and less lucrative. There are no procedures. Yes. So I mean, it's so rewarding. But we for decades have been lamenting the dearth of geriatricians. And so in addition to thinking that, of course, it still go forward. We do need to incorporate into every single curriculum a whole bunch about aging and recognize that ageism impacts physicians and nurses and front office people. And, you know, this notion that we're just less than or we shouldn't be listened to. I had one patient who really had a lot of lumps in her breast and was told it was just because she was in her eighties. But what this woman said, and I'll always remember it because I'm going to say it, is she said, you know something, dear, this breast is also in its eighties. And there are no lumps in there. I thought, you know, like standing up for ourselves. Why do you see paternalism here? Very much so. Yes. Like this is for your own good. Yes. And I think we have to look at our own selves because think about paternalism. It is every time that you see an older person and you think or say how cute you are, we're not doing ourselves any favors. And I know listeners, you're you're doing it to be kind. You say, I mean it as a compliment. I just think you or your mom is really cute. It's really not a path we want to be going to. So if we could stop with old people cute, we're not. And if somebody says to you as we get older, let's say you're in your seventies, eighties, nineties, one hundredths, and someone says that's cute or that's so amazing that you're still doing this or, oh, you don't even look 80. It's it's healthy for society to stand up and say, oh, I got over being cute a long time ago. I'm vital. I'm strong. I'm smart. I'm a bad ass. The reactive medicine, which is what I feel like that's all that's left for the aging population. Like where do you think we can do work? Is there a place for medicine to be proactive here with aging patients? Yes. I think that recognition about quality of life and about how many years you have left and about asking the patient what matters to them can really guide. And we've done good work, the National Institute on Aging of recognizing, ask patient what matters to them, you know, instead of just assuming that if we can come in and get these lower, what things do you want to be able to do? So to treat the human, not just the body, the algorithm would truly improve life. So in our clinic, we do, you know, we put out the fire of menopause if she's having symptoms and that's the easiest part of my job. And then because no one else is kind of stepping up and it's something that I love and is fascinating me. I just think it's such a beautiful part of medicine is, is building this like runway. But I always ask the patients, what scares you? What are you worried about? What do you want? What can I do for you? How can we create this path, this toolkit so that you can live the life you want? Whatever that looks like. And for most of my patients, not all, but most of them it is, I don't want to live to 120. I've never heard a patient say that yet. Most of them are, I don't want to be a burden. I want to be a benefactor. I want to live as healthy as possible for as long as possible. And I don't want that last decade to be filled with pain or worry. Yes. So is that possible? Yes. And I think, you know, part of it that we've talked about before is recognizing the contribution of older people is is the wisdom that they bring and the inherent value of the human, even when you are bedbound, even when you have significant vision impairment or when you're deaf or these kinds of things is that like to recognize you're not going to be a burden. We're going to, you know, to comfort people that their life matters and that they matter and that we're going to together work to find a way not to just make you languish in pain, contracted in bed. Yes. Because no woman wants that. They're not like, yeah, I want to live to 120 and be in bed and incontinent and not be able to remember any of it. Yes. You know. And we have to really as clinicians be really good listeners. So by saying what matters to you and then you hear them say, you know, what matters to me, I really want to be able to get out in the garden. So maybe, yeah, we don't need to be driving right now. But maybe if we could find a way that we could have a raised flower bed so that you could keep doing it, it's going to be different for everyone. And that's another irony of growing older is that sometimes we look more the same. But in fact, it's the most heterogeneity, the most difference that we've ever had is when we get older. And it's a blessing. But I feel like we have a long way to go in the way most people are able to access medical care and we have these time limited visits in 15 minutes. Fix the problem. Everything is so reactive right now. And this is a giant bandaid slapped on a very broken medical system. And I think the aging, having dealt with it with now, you know, both sets of parents, I think our parents are paying the price. Yes. Mine certainly have my father-in-law who recently passed away. I'm right up until practically the moment that he passed. Doing all these treatments and all these things that was decreasing the quality of his life. And at one point they said, we're going to put in a feeding tube and think, heaven, I was there. I was like, are you joking me? He's going to pass in any day now. No, we're not going to be doing that because a lot of times, unfortunately, the physicians haven't had the training on what is really going on here, that this is a person and that death is not the defeat. Some people are so resistant to the word hospice, but I don't think they understand it's either live at any cost. Yes. Tubes and wires and all the things, you know, and get your paperwork signed if you don't want any of that. But God forbid you don't. You're going to be on life support. Yes. Versus do nothing. And I think they don't understand there's such a wide variety of how you can live. Yes. I'm so glad you brought up hospice. It is great. And people can be on hospice and live quite a long time. There's no, you can keep living great, but you can, we can address the pain. You can make sure you're not alone. We can have great environments and you've got to die. We're all going to die. It's OK. We're supposed to. And that thing of like, just don't die, don't die, don't let my parents die, don't let my husband die. We've not thought this through. Right. Think about it. Why are we thinking this through? No, I think it's because everybody got to really think about it because I sat at the bedside and watched three of my brothers. Well, two, I was nine when the first one died. You know, my dad, which was beautiful and, you know, and my two brothers, which were horrible because they were so young and, you know, they should live longer, I hope you know, but they didn't. So I've thought a lot about this and I am so OK with that. Yes. Because you've thought about it. So let's let ourselves think about it and talk about it and it's not morbid. No, maybe you want to talk about it with your adult children. And when they say, no, no, mom, you're fine. Let's not talk about it. You say, I know I'm fine. I am ahead of you in this journey. I want to talk about it. I want you to know that it's OK. You know, I want you to know that we are reformatting what it means to grow old and die. We're making it up as we go and we're making it better by being proactive. Let's talk about adaptation. I think that scares a lot of people. But why is do you think the ability to adapt is more important than avoiding hardship? I guess because hardship is going to come. It's going to come. And you can put your head in the sand and say, nothing, that's going to happen to me, nothing ever will be hard. And that's a lie. It will, because that's humans. That's humanity and stuff happens. You're not alone. We all have really like stuff. And usually you don't know the stuff that other people have because they're carrying it in a way that doesn't show. So get your head out from under the la la and say, because I'm human, there's going to be lovely things and there's going to be heartbreaking, hard things. And I'm going to be OK because otherwise it's just suffering twice, right? When the hard thing happens, it's like if you fall to pieces and everything is just. But if you can say, I don't like it, that my life partner, love of my life has passed away prematurely when I imagine we were going to have a retirement together. I thought we were going to hike everywhere and instead it's just me for the last 40 years, I did not think that that was going to be the case. Feel it, share it with other people, but then recognize, huh, I might be on this earth for however many decades, can I adapt to this new normal that I didn't wish for? And the answer is you can. Over time, with little steps, I want that for you because I don't want you to lead the last decades of your life in pure suffering because I see it over and over again, I'll have patients tell me I'll never be happy again. I'll never enjoy life because then they'll give the reason. And on the one hand, I understand it, but on the other hand, I don't want that for them. I would like them to squeeze the remaining joy out of life. And I think that's what our loved ones would want for us too. Yeah. What gives you the most hope about the future of how we age? It sounds like a brown noser response, but it's you. It is because the work that you're doing and in listening to all those episodes, it is women and humans coming together and saying it can be better. We can listen, we can empower, we can strengthen, we can lift other people up, which is what you've really done for me. That's a stranger. You were like, I came across this book and I'm going to share it and we can be doing that for each other. So I feel really, really hopeful that there's going to be a critical mass of humans, men and women coming together and saying we can do better when it comes to longevity. We're seeing, I guess, culturally a big transfer of wealth from traditionally male, you know, and what's important to them. And then I've read the statistics that we're seeing that wealth transferred to females in a way that it's never happened in history. And then I'm seeing some of those women really stepping into funding and research. And like, how can we make the world better for all humans, especially for women and their health and their longevity and their aging and and because they want a better future for their their children than what the world has built at such a great point because there are so many Americans who don't have the financial resources and they really and to age. Yes. Patients who say, I don't know if I should take this life saving medication or if I should eat or if I should pay my rent. That's the decision. And so the hope of we as a society recognizing that, yes, there's a component of fortifying ourselves, but our societal and the safety net and how we practice medicine needs to change. And if women are leaning into supporting that, which is I've been seeing too. And if we each continue to recognize what we have to give and then give it. So some people, it's going to be money. Great, I'm all for it. Some people is going to be just the patients or the mentoring somebody else. Or women recognizing I'm going to use that whole longer life for the good of others and society and myself and my joy. That's a revolution. That is really helpful. I love that. So we're going to list everything in the show notes. But where can our listeners find you? You can find me sitting on the beach with my golden retrievers. But you could also I would be so grateful if people would like to read and gift joy span and people will ask you what age is it for? It's for all ages. You can give it as a gift and it doesn't. Yeah, it doesn't make or I'm giving this to because you're older. It's just it's for everybody. It's about well-being. I'm so honored to have had the opportunity and a lot of libraries have it. That's a good way to get it and get it on audible. One time you said joy span and I was so excited and I want people to use the term joy span. So I proactively didn't trademark it because I want people to use it like they use life span and health span. It's everybody's like let's talk about joy can be for everybody. And I mean, leaning into a teaching phase. I'm having started at University of Chicago and good for you. I'm so happy about it. Faculty too. Isn't it nice? My teaching is people 50 and better. So people are recognizing that they have these long lives and they have all this intellectual curiosity and so much to give. So all the teaching I'm doing is people who are our age and better. And it is so much fun because I'm learning more than I ever could teach. Well, thank you so much for coming on on pause. I'm sure listeners are going to love this episode. Well, just imagine me listening to every single thing you put out. I will be there. All right. Thank you. You're welcome. You can find Dr. Kerry Burnight on Instagram at the underscore gerontologist or through her website, Dr. Kerry Burnight dot com. You can find full episodes of Unpaused on YouTube at Dr. Mary Claire. I'd love to hear from you about this topic or anything else that's on your mind. You can find me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness and navigating midlife at the pause life dot com. My new book, The New Perry Menopause is available on Amazon or anywhere you buy books. If you're loving this podcast, I have an important request. Follow Unpaused on your favorite podcast app. Following and listening is what pushes this information forward to more women who need it. So if this podcast has helped you or you feel seen, understood and supported, hit follow right now so you never miss an episode. Thank you for being here with me. Let's keep going. Unpaused. Unpaused is presented by Odyssey in conjunction with Pod People. I'm your host, Dr. Mary Claire Haver. The views and opinions expressed on Unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.